Lin Huang-Li, Chou Hung-Hsueh, Liu Chia-Yih, Hsu Shi-Chieh, Hsiao Mei-Chun, Juang Yeong-Yuh
Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC.
Chang Gung Med J. 2011 Jan-Feb;34(1):57-64.
The purpose of this study was to investigate the consultation psychiatry service to the Obstetrics and Gynecology Department in a general hospital, focusing on referral patterns and consultation recommendations.
A retrospective review of the medical charts and consultation records of obstetric and gynecological patients referred for psychiatric consultation from Dec. 2003 to Nov. 2009 was performed.
One hundred and eleven patients were referred during the 6-year period, a psychiatric referral rate of 0.11% among 99,098 obstetric and gynecologic admissions. Obstetric and gynecologic consultations comprised 0.64% of all psychiatric consultations. The most common reasons for referral were depression (52.25%), past psychiatric history (31.53%), insomnia (29.73%) and confusion (24.32%). The most common DSM-IV psychiatric diagnoses were depressive disorder (37.84%), schizophrenia and other psychoses (20.72%), delirium (17.12%) and adjustment disorder (10.81%). The most frequent physical diagnoses of referred patients were neoplasms (72.97%), infectious diseases (42.34%) and complications of pregnancy and puerperium (17.12%). Recommendations included pharmacological intervention (89.19%) and psychological management (72.07%).
The psychiatric referral rate of obstetric and gynecological inpatients was relatively low compared with that of other departments. More collaboration and liaison between gynecologists and consultation psychiatrists may provide better care for obstetric and gynecological inpatients.
本研究旨在调查综合医院妇产科的会诊精神病学服务，重点关注转诊模式和会诊建议。
对2003年12月至2009年11月转诊进行精神科会诊的妇产科患者的病历和会诊记录进行回顾性研究。
在6年期间共转诊111例患者，在99,098例妇产科住院患者中的精神科转诊率为0.11%。妇产科会诊占所有精神科会诊的0.64%。转诊的最常见原因是抑郁（52.25%）、既往精神病史（31.53%）、失眠（29.73%）和意识模糊（24.32%）。最常见的DSM-IV精神科诊断为抑郁症（37.84%）、精神分裂症和其他精神病性障碍（20.72%）、谵妄（17.12%）和适应障碍（10.81%）。转诊患者最常见的躯体诊断是肿瘤（72.97%）、传染病（42.34%）以及妊娠和产褥期并发症（17.12%）。建议包括药物干预（89.19%）和心理治疗（72.07%）。
与其他科室相比，妇产科住院患者的精神科转诊率相对较低。妇产科医生与会诊精神科医生之间更多的合作与联络可能会为妇产科住院患者提供更好的护理。
